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Top 7 Fraud-Fighting Tips to Protect Health Benefit Plans

Posted by Medavie Blue Cross on March 11, 2024

Top 7 Fraud-Fighting Tips to Protect Health Benefit Plans

Posted by Medavie Blue Cross on March 11, 2024

March is Fraud Prevention Month, reminding us of the role we can all play in recognizing, rejecting and reporting health insurance fraud. This type of fraud can involve submitting false, deceiving, or misleading information for the purpose of financial gain. It can take many forms, from backdating a disability claim to submitting a fictitious or inflated medical or dental claim.

Making a fraudulent claim is a serious crime that hurts everyone. The financial losses from health insurance fraud can lead to higher premiums, decreased coverage for plan members and their families, and job layoffs in cases of large-scale fraud.

How You Can Prevent Fraud

We all have a vested stake and shared responsibility in fighting fraud, and the best way to do that is to prevent fraud from happening in the first place. Here are some ways to do that.

Top 7 Fraud-Fighting Tips

  1. Protect your personal information at all times, including information to access your benefit plan.
  2. Don’t let someone borrow your benefit plan ID card for a health service or product.
  3. Always question a provider who offers free items with a service or product or when a provider offers to waive your co-pay or deductible.
  4. Don’t sign your name on a blank claim form.
  5. Check your receipts to ensure they match the product or service you received. You can check your claim history through the Blue Cross Mobile app or the Member Services Site.
  6. Keep your receipts in case you need them to support your claim.
  7. If you have questions about your provider and ⁄or suspect fraudulent activity, contact us using our confidential and secure fraud and ethics reporting service.

How You Can Report Fraud

Administered by an external third party, the Medavie Blue Cross Fraud and Ethics Reporting Service offers a safe space to voice your concerns about possible plan fraud or abuse. The service is quick, easy to use, and completely anonymous. You can file your report through a secure website or by calling toll-free at 1-800-661-9675. Professionally trained, bilingual agents are available 24 hours a day to take your calls.

Learn more

Visit the fraud prevention page on our website to learn more about how the service works and our fraud prevention program.

Visit the Canadian Life and Health Insurance Association’s Fraud=Fraud web page to get more tips on how to sharpen your fraud-fighting skills.

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